- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- Fact Check
- Bone Health Fact Check
- Brain Health Fact Check
- Cancer Related Fact Check
- Child Care Fact Check
- Dental and oral health fact check
- Diabetes and metabolic health fact check
- Diet and Nutrition Fact Check
- Eye and ENT Care Fact Check
- Fitness fact check
- Gut health fact check
- Heart health fact check
- Kidney health fact check
- Medical education fact check
- Men's health fact check
- Respiratory fact check
- Skin and hair care fact check
- Vaccine and Immunization fact check
- Women's health fact check
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
State of Rapid sequence induction in pediatric anesthetic practice in India: A survey
The use of rapid sequence induction (RSI) is a well-established method employed to effectively protect the airway in individuals who have a heightened susceptibility to aspiration. The procedural elements of "classical RSI" include many consecutive phases, which consist of preoxygenation, induction with thiopentone, application of cricoid pressure, administration of succinylcholine, avoidance of bag-mask ventilation, and quick tracheal intubation. The use of rapid sequence intubation (RSI) in the pediatric population exhibits significant variability as a result of many patient-related variables. The aforementioned circumstances have resulted in heterogeneity among pediatric anesthetists about the use of traditional rapid sequence induction (RSI), leading to the adoption of modified RSI (MRSI) as an alternative approach. The use of rapid sequence intubation (RSI) in the pediatric demographic exhibits significant variability as a result of many patient-related variables. A recent study was undertaken to investigate the prevailing practices and adherence of anesthesiologists to the practice of rapid sequence intubation (RSI) in various pediatric age cohorts, as well as to determine whether there are any variations based on the anesthesiologist's level of expertise or the age of the child.
Residents and consultants who attended the national pediatric anesthesia conference were surveyed. The survey had a total of 17 inquiries pertaining to the professional background, adherence to guidelines, execution of pediatric rapid sequence intubation (RSI), and the factors contributing to nonadherence among anesthesiologists.
The response rate achieved in the study was 75%, with 192 out of 256 participants providing a response. Respondents with fewer than 10 years of experience in the field of anesthesiology had a higher adherence rate to rapid sequence intubation (RSI) as compared to those with greater levels of expertise. Succinylcholine emerged as the prevailing muscle relaxant for the purpose of induction, with a notable rise in use across older age cohorts. The use of cricoid pressure shown an upward trend as the age groups rose. Anesthetists with more than ten years of experience shown a higher frequency of using cricoid pressure in age groups less than one year, with statistical significance (P < 0.05). In the context of intestinal obstruction, the level of adherence to Rapid Sequence Intubation (RSI) was shown to be comparatively lower in pediatric patients as compared to adults. This was supported by the agreement of 82% of the respondents.
The findings of this study pertaining to the implementation of Rapid Sequence Intubation (RSI) in the pediatric population reveal substantial heterogeneity in practice patterns among healthcare professionals, as well as the underlying causes contributing to noncompliance, in contrast to the adult population, despite the presence of perceived risk factors. The findings of this survey indicate a prevalent desire among the participants for more research and the implementation of protocol-based practices in the field of pediatric rapid sequence intubation (RSI). It is essential to provide comprehensive training to trainees in pediatric Rapid Sequence Intubation (RSI) to ensure their proficiency in executing all aspects of RSI with confidence.
Reference -
Hussain, Sana Yasmin; Panjiar, Pratibha; Jain, Dhruv1,; Khanooja, Samiksha; Batt, Kharat Mohammad. Current practice of Rapid Sequence Induction (RSI) in pediatric anesthesia: A survey from India. Journal of Anaesthesiology Clinical Pharmacology 39(1):p 88-97, Jan–Mar 2023. | DOI: 10.4103/joacp.joacp_172_21
MBBS, MD (Anaesthesiology), FNB (Cardiac Anaesthesiology)
Dr Monish Raut is a practicing Cardiac Anesthesiologist. He completed his MBBS at Government Medical College, Nagpur, and pursued his MD in Anesthesiology at BJ Medical College, Pune. Further specializing in Cardiac Anesthesiology, Dr Raut earned his FNB in Cardiac Anesthesiology from Sir Ganga Ram Hospital, Delhi.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751